Bed Wetting

Question 1

What question do we ask in bed wetting with regards to primary vs secondary enuresis

Answer 1

Have they always been wetting their bed or have they had periods of no wetting?

=> Always wetting - Primary
=> Only just started - Secondary

Question 2

What question do we ask in bed wetting with regards to sleep?

Answer 2

Are they a heavy / deep sleeper thats hard to wake up?

Question 3

With GI hx in bed wetting ,what do we need to ask them?

Answer 3

Are they constipated

Question 4

1st line management of bed wetting (4)

Answer 4

2wk diary of fluid intake / toileting / bed wetting episodes

Changes to fluid intake before bed

If constipated => Movicol

Positive reinforcement + Star chart

Question 5

What happens in bed wetting if conservative efforts failed before medication?

Answer 5

Enuresis alarm

Question 6

What 2 drugs can be given in bed wetting?

Answer 6

Oxybutynin

Desmopressin (nocturnal enuresis)

Question 7

How does oxybutynin work?

Answer 7

Relaxes the bladder reducing unwanted contractions

Question 8

How does Desmopressin work?

Answer 8

Calms down an overactive bladder

Question 9

How to screen for urge + stress incontinence?

Answer 9

Do you get daytime wetting?

Question 10

If Pt has daytime + nocturnal wetting, what is this called

Answer 10

Mixed incontinence of Urge / Stress + Nocturnal Enuresis

Question 11

Oxybutynin works as a?

Answer 11

Anticholinergic / Antimuscarunic